Early results of open-heart surgery for acquired heart diseases in Ibadan, Nigeria

M. Salami, O. Akinyemi, V. Adegboye
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引用次数: 3

Abstract

Background: Cardiovascular disease burden is disproportionately high in Sub-Saharan Africa (SSA) where resources to provide optimum care for cardiothoracic patients are still very limited. Previous reports of open-heart surgery from new centers in SSA have shown a preponderance of valvular heart disease in published series, with wide variations in reported morbidity and mortality. Objectives: We report on a series of patients who underwent open-heart surgery for acquired heart diseases to demonstrate pattern of disease, type of cardiac surgery done, and our results. Methods: We conducted a retrospective review of patients who had open-heart surgery for acquired heart diseases between October 2013 and November 2016. Data collected included demographics, presenting symptoms, indication for surgery, preoperative evaluation and preparation, operative procedure, postoperative complications, and follow-up. Statistical analysis was carried out descriptively using frequencies and percentages. Results: A total of 35 patients have undergone open-heart surgery between October 2013 and November 2016. The patients who had surgery for acquired heart disease were 17 (48.6%). These included valvular heart disease in 13 patients while the remaining patients had coronary artery bypass grafting (CABG) for ischemic heart disease. The mean age of patients who had valve replacement and CABG were 39 and 60 years, respectively. Parsonnet risk scoring was used with an average score of 8.5. Three (17.6%) patients were in good risk category while 7 (41.2%) patients each were in fair and poor risk categories. Postoperative complications included paravalvular leaks in two patients. There was no hospital mortality. Conclusion: Early results of valvular and coronary artery bypass surgeries from our center show good outcome comparable to global standards with zero hospital mortality and low morbidity. The result is aided by good case selection, adequate preparation, and teamwork.
尼日利亚伊巴丹对获得性心脏病进行心脏直视手术的初步结果
背景:撒哈拉以南非洲(SSA)的心血管疾病负担高得不成比例,为心胸病人提供最佳护理的资源仍然非常有限。先前来自SSA新中心的心内直视手术报告在已发表的系列文章中显示瓣膜病占优势,报道的发病率和死亡率差异很大。目的:我们报道了一系列因获得性心脏病而接受心脏直视手术的患者,以证明疾病的模式、所做心脏手术的类型和我们的结果。方法:回顾性分析2013年10月至2016年11月期间因获得性心脏病接受开胸手术的患者。收集的资料包括人口统计学、表现症状、手术指征、术前评估和准备、手术程序、术后并发症和随访。采用频率和百分比进行描述性统计分析。结果:2013年10月至2016年11月共35例患者接受了心内直视手术。手术治疗获得性心脏病17例(48.6%)。其中13例为瓣膜性心脏病,其余为缺血性心脏病患者行冠状动脉旁路移植术(CABG)。瓣膜置换术和冠脉搭桥患者的平均年龄分别为39岁和60岁。采用帕森内特风险评分法,平均得分为8.5分。良好风险3例(17.6%),一般和不良风险各7例(41.2%)。术后并发症包括2例患者瓣旁渗漏。没有医院死亡率。结论:我们中心的瓣膜和冠状动脉搭桥手术的早期结果显示出与国际标准相当的良好结果,医院死亡率为零,发病率低。这一结果得益于良好的病例选择、充分的准备和团队合作。
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